Teen girls are susceptible to developing eating disorders due to the pressure society and the media places on girls to attain an “ideal” body.[1] Consequently, eight times as many females as males develop eating disorders, the majority of which afflict teens.[2] Bulimia, binging, and anorexia can all pose serious health risks, and being able to identify these disorders is important for anyone with influence on teen girls as a parent, teacher, counselor, relative etc.

Steps

Method1

Looking for Signs of an Eating Disorder

1

Look for dramatic weight changes. Weight loss is common with eating disorders, especially anorexia and bulimia. Weight may drop dramatically from the starting point, or drop below a healthy weight. Conversely, those with a binge-eating disorder will gain weight rapidly. The absence of dramatic weight change should not be taken as evidence there isn't a problem.

Eating disorders don't develop overnight. Any responsible adult should aim to identify a problem before the teen is dangerously under- or overweight. Incremental changes in weight over a long period can also occur, which can make it difficult to spot as a problem when you know the teen well and see her frequently.

Not every weight change is associated with an eating disorder. As teenagers grow, they may lose or gain weight. If you observe a dramatic loss of weight in conjunction with other symptoms, consider confronting the teen girl with your concerns.

When a teenage girl is 15% or more outside her normal weight, she may have an eating disorder.

Look for evidence of purging. Teenage girls with bulimia will expel food from their stomachs through induced vomiting (purging). If you’re a parent at home and hear or see your daughter retching, or detect the scent of vomit in the bathroom after she has been in there, she may be suffering from bulimia.

If detected, she might excuse the vomiting as an illness, such as stomach flu rather than self-induced purging.[4] If she’s sneezing, stuffy, coughing, and/or has a temperature, she’s being honest; but remember, flu isn't always accompanied by vomiting. If there's no reason for the vomiting, such as food poisoning, she may have an eating disorder.

A teen girl who purges might also take multiple showers each day in order to wash the vomit down the drain and minimize the odor.[5]

4

Keep an eye out for laxatives or diet pills. Diet pills block the body’s absorption of fat or curb the appetite, while laxatives encourage bowel movements. Both may be employed by individuals with eating disorders in order to keep food out of their body and restrict the absorption of calories.

5

Look for extreme eating habits. A teen girl with an eating disorder may binge on a large amount of food at one time, but at other times refuse to eat for long stretches. She may eat very little, or implement very strict rules about her eating such as only eating at certain times or only eating certain types of food. Fasting or skipping meals regularly can also indicate an eating disorder.

Alternately, a girl who binges may constantly snack throughout the day and regularly consume 5,000–15,000 calories in one sitting.[6]

If you’ve had large volumes of food go missing from the fridge, the teen may be binge-eating.

6

Watch for sudden changes in eating habits. Eating habits might change quickly and dramatically, or change slowly over time. A girl who suddenly refuses to eat anything but “diet,” fat-free, or low-fat foods may have an eating disorder. Alternately, a girl who exclusively eats sweets, high-fat foods, or drinks only soda may be a binge eater.

For example: If you notice she no longer eats her favorite junk food, this may be a sign that she has an eating disorder.

7

Look for an increased activity regimen. Body-image issues may manifest as a desire to reach some ideal body type through intense exercise. Perhaps she has increased her workout routine from an hour or so to three or four hours of progressively more intense exercise each day?

While regular exercise is good, if you sense the teenage girl’s exercise habits are getting out of hand and interfering with her social or academic life, consider talking with her about your concerns.

8

Note obsessive behaviors regarding food. These may include a refusal to eat certain ingredients, measuring portions exactly, or counting calories in every item she eats or drinks. These behaviors suggest an excessive and unhealthy preoccupation with food which could indicate an eating disorder.[7]

If she’s taken up reading diet cookbooks, watching cooking shows on TV, or reading about new low-calorie recipes online, she might have an obsessive food disorder. Since these behaviors can be healthy and are not inherently indicative of the existence of an eating disorder, you should only consider them signs of an eating disorder if she also displays other warning signs as well.

Method2

Communicating With Your Teenager to Uncover an Eating Disorder

1

Have her talk to a doctor or counselor. General practitioners can help provide a definite diagnosis as to whether a teen does or does not have an eating disorder. Monitoring the teen’s weight over a long period and examining internal features like the condition of the throat (which may be swollen or irritated due to repeated contact with stomach acid following regurgitation) are clues doctors can use to determine if your teen is dealing with an eating disorder.

After detecting your teenage girl’s eating disorder, getting her a thorough medical evaluation should be your first response. A clinical physician as well as a psychiatrist should be consulted in order to gauge the best course of treatment. Doctors specializing in eating disorders can help chart her recovery and write prescriptions if necessary.

In some cases, family counseling might be necessary.[8] This is important because it both allows the teenage girl to receive the active support of her family and gives the counselor a fuller, more objective picture of the girl’s progress in fighting the eating disorder.

2

Decide if you should talk to her directly or talk to her parents. If you are a teacher, coach, or other adult authority figure who is not the girl’s parent, you might talk to the teenage girl directly but you should in all cases bring your concerns to her parents, either directly or in addition to talking with the girl. They will be best equipped to take on the long-term responsibility of assisting her on her path to recovery.

The most important thing when confronting a girl about her eating disorder is not really who you are, but how you express your concerns.[9] Carry out the conversation in a place where the girl feels secure and safe, like in her home. (For this reason, it’s best to have a family member confront the girl about her eating disorder.)

Do not broach the issue if you or the teenage girl in question are eating or in a tired or emotional state.

Be sensitive to the shame or embarrassment the girl may be experiencing due to the eating disorder, and always be gentle and understanding when confronting her about her habits. Do not blame her for her eating disorder; instead, express that you are worried about her and ask her about her feelings.

3

Ask if she is experiencing irregular menstruation. Discerning if she’s been having regular periods is a good way to figure out if she has an eating disorder. Two or more skipped periods in girls, along with a loss of weight, is a good signal that she has an eating disorder. Remember, though, weight gain and missed periods could also indicate pregnancy.[10]

This question might sound more sensitive when coming from mom or another sympathetic female family member than from dad.

4

Listen for excuses as to why she’s not eating, or for changing her diet. If the teenage girl often uses convoluted or contradictory reasons as to why she’s eating a certain way, she might be covering the fact that she’s developed a disorder.[11] For instance, she may claim that she ate a big snack before a meal and so doesn’t need to eat dinner, or claim that she will be eating later at a friend’s house.

5

Pay attention to body image issues. If a teen girl is constantly obsessing about her weight and thinks she's overweight when she is actually a healthy weight, it's possible that she is also struggling with an eating disorder. Other body image signs include buying clothes in too-small sizes (known as "inspiration shopping") and collecting images of very thin celebrities and models ("thinspo" or "thinspiration").

She may also check the mirror frequently for perceived body flaws.[12]

She may frequent "pro-ana" (pro-anorexia) or "pro-mia" (pro-bulimia) forums or pages on Tumblr or other online social media.

6

Listen for expressions of revulsion concerning her weight and eating habits. She may say that she hates eating, or wishes she was thinner. She may constantly complain that she is fat or flabby. She might also express disgust, guilt, or shame about how much she eats (whether it’s too much or too little).[13]

7

Note mood changes. The girl's mood may change, and she may suffer from extreme mood swings. Some moodiness is normal for a teenage girl, but moodiness in addition to eating habits, or extreme moodiness when asked to deviate from an eating routine, may be a sign that malnutrition which attends an eating disorder is altering her behavioral patterns.[14]

8

Look for signs of anxiety at mealtime. Teenage girls with anxiety may suffer from anxiety related to food. She may show signs of discomfort or stress surrounding conversations about food and eating. She may also show discomfort around the act of eating, and refuse taking meals with family or friends.[15]

Anxiety may manifest as anger related to food. She may become very insecure, angry, or withdraw from a conversation about food, eating or weight gain/loss.

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Tips

Refusal to eat something may be a symptom of normal teen rebellion and assertion of self, or it may be symptomatic of an eating disorder. Carefully monitor your daughter’s eating habits to ensure she is eating enough and properly.

If you diet and obsess over your weight, your kids might too. Be aware of your behavior when around teens and talk to them in a proactive way about the differences between adult and teen bodies. Try not to comment on your body, her body, or the appearance of others.

Get your teen help as soon as a problem becomes apparent. Medical diagnoses from both a psychiatrist and a general practitioner will set her on the recovery path.

Always be supportive of your teenage girl with an eating disorder. Show her you're there for her.

Warnings

Don't assume that a girl can't have an eating disorder because she is heavy. Eating disorders are a mental health issue, not a body size issue. Many girls have eating disorders at all different sizes.

Do not ask if she has an eating disorder if you do not know her very well. This will upset her and make her more defensive and secretive.